Alan Maynard calls public health doctors 'purchasers' - a portmanteau word with little operational consistency. What one health authority understands by the term will differ from another, and what it does in practice is something else again. We are witnesses of this confusion, not its creators.

We hack on, bringing epidemiological and economic reason to bear where possible, while trying to get on with our real work of improving population health.

Dr Graham C Sutton Senior clinical lecturer Nuffield Institute for Health Leeds University